This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hanson, K. E.
Right arrow Articles by Reller, L. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hanson, K. E.
Right arrow Articles by Reller, L. B.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, March 2007, p. 721-724, Vol. 45, No. 3
0095-1137/07/$08.00+0     doi:10.1128/JCM.01950-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Validation of Laboratory Screening Criteria for Herpes Simplex Virus Testing of Cerebrospinal Fluid{triangledown}

Kimberly E. Hanson,1,2* Barbara D. Alexander,1,2 Christopher Woods,1,2,3 Cathy Petti,4 and L. Barth Reller1,2

Division of Infectious Diseases and International Health, Department of Medicine,1 Clinical Microbiology Laboratory, Department of Pathology, Duke University Medical Center, Durham, North Carolina,2 Division of Infectious Diseases, Department of Medicine, Durham VA Hospital, Durham, North Carolina,3 Departments of Medicine and Pathology, University of Utah School of Medicine, Salt Lake City, Utah4

Received 19 September 2006/ Returned for modification 8 November 2006/ Accepted 18 December 2006

Most patients with herpes simplex virus (HSV) central nervous system (CNS) infection have abnormal cerebrospinal fluid (CSF) indices. Therefore, we implemented screening criteria based on CSF values and host immune status to guide testing. All CSF samples submitted for HSV PCR analysis from January 1999 through December 2004 were included in the study. Specimens from patients with human immunodeficiency virus, a history of transplants, an age of <2 years, a CSF white blood cell count of >5 cells/mm3, or a protein level of >50 mg/dl were tested upon request. All other samples were rejected and frozen. To validate our screening criteria, rejected specimens were pooled and tested retrospectively. Electronic medical records were also reviewed. A total of 1,659 HSV PCR requests from 1,458 patients were screened. Of the 1,296 specimens (78.1%) accepted for testing, 1,213 were negative, 7 were positive for HSV type 1 (HSV-1), 26 were positive for HSV-2, and 50 had unavailable results. Sixteen requests were rejected because an alternative microbiologic diagnosis had been established. Of the 347 samples rejected based on criteria, 222 (64.0%) remained available for pooled testing. No HSV-1-positive samples were identified in the rejected specimens. Two rejected specimens tested positive for HSV-2 DNA, but both met acceptance criteria which had not been communicated to the laboratory. Few patients (7.8%) with rejected specimens were treated with acyclovir, which suggests a low clinical concern for HSV encephalitis. Acceptance criteria based on CSF parameters and host immune status saved time and cost and did not miss patients with HSV CNS infection. Communication between the clinician and the laboratory is imperative for a successful screening program.

* Corresponding author. Mailing address: Duke University Medical Center, Box 3879, Durham, NC 27710. Phone: (919) 668-0789. Fax: (919) 684-8519. E-mail: kim.hanson{at}duke.edu.

{triangledown} Published ahead of print on 3 January 2007.

Journal of Clinical Microbiology, March 2007, p. 721-724, Vol. 45, No. 3
0095-1137/07/$08.00+0     doi:10.1128/JCM.01950-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • LeBlanc, J. J., Campbell, S., Pettipas, J., Hatchette, T. F., Davidson, R. J. (2008). Herpes Simplex Virus Type 2 Displays Atypical Melting-Temperature Profiles at Low Viral Titers. J. Clin. Microbiol. 46: 2786-2789 [Abstract] [Full Text]  
  • Reil, H., Bartlime, A., Drerup, J., Grewing, T., Korn, K. (2008). Clinical Validation of a New Triplex Real-Time Polymerase Chain Reaction Assay for the Detection and Discrimination of Herpes simplex Virus Types 1 and 2. J. Mol. Diagn. 10: 361-367 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»